Provider Demographics
NPI:1003685868
Name:ALVAREZ TAMAYO, YOANKA
Entity Type:Individual
Prefix:
First Name:YOANKA
Middle Name:
Last Name:ALVAREZ TAMAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 NASHVILLE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2048
Mailing Address - Country:US
Mailing Address - Phone:813-644-6538
Mailing Address - Fax:
Practice Address - Street 1:5103 NASHVILLE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2048
Practice Address - Country:US
Practice Address - Phone:813-644-6538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-31-7357106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician